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                 The  Enacted  Unconscious:  A  Neuropsychological  Model  of    

                          Unconscious  Processes  and  Therapeutic    

                             Change  

This  paper  presents  an  integrated  neuropsychological  model  of  the  

unconscious  and  explores  its  relevance  to  therapeutic  change.  Following  

Freud  (1915),  some  of  the  more  traditional  conceptualizations  of  the  

unconscious  have  viewed  it  as  a  separate  mental  entity.  It  has  been  seen  

as  containing  well-­‐delineated  memories,  forbidden  wishes,  conflicts  or  

traumatic  experiences  that  were  made  unconscious  because  they  could  

not  be  tolerated  by  one’s  conscious  sense  of  self.  Such  approaches  

assumed  that  uncovering  repressed  or  dissociated  experiences  would  

make  the  unconscious  conscious,  leading  to  psychic  integration.  As  we  

are  learning,  however,  the  immense  unconscious  system  does  not  

confirm  to  this  view.  The  widespread  networks  that  always  hum  in  the  

background  and  give  rise  to  our  conscious  states  cannot  be  reduced  to  

specific  events,  memories,  and  content.  This  unconscious  background  is  

an  amalgam  of  fused  perceptions,  memories,  and  emotions,  many  of  

them  created  before  conscious  memory  is  viable,  and  others  the  result  

of  unconscious  associative  learning  processes.  

An  integration  of  current  thinking  and  findings  in  

neuropsychology  with  psychoanalytic  knowledge  reveals  a  new  model  

of  the  unconscious.  Rather  than  a  static  and  hidden  aspect  of  our  

psychological  structure,  the  unconscious  can  be  described  as  on-­‐going  

brain/mind  processes  that  underpin  much  of  who  we  are.  The  new  

model  highlights  the  connection  between  unconscious  and  conscious  

processes,  and  especially  the  brain/mind’s  propensity  to  automatically  

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enact  entrenched  patterns.  More  significantly,  this  new  understanding  

clarifies  the  recurrent  difficulties  that  often  confront  both  therapists  

and  patients—the  perniciousness  of  repetition  and  the  struggle  to  

achieve  sustained  therapeutic  change.  The  new  understanding  begins  to  

answer  the  following  questions:  Why  are  emotional  and  behavioral  

difficulties  so  enduring,  stubborn,  and  repetitive,  even  when  we  gain  

insight  and  think  we  can  exert  willful  influence  on  our  feelings  and  

actions?  Why  do  people  continue  to  engage  in  behaviors  and  

interactions  that  cause  misery  to  themselves  and  others?  

Customary  interpretations  of  what  is  often  seen  as  resistance  

suggest  that  “failure”  to  change  is  guided  by  an  almost  willful  

attachment  to  adverse  self-­‐states  and  behaviors,  by  dynamically-­‐

motivated  defensive  reasons,  or  by  a  pathological  connection  to  old  self-­‐

object  representations.  At  times  secondary  gains  are  considered  as  well.  

These  explanations  do  not  help  us  grasp  the  underlying  reasons  for  such  

impediments  to  change.  Indeed,  unconscious  patterns  are  resistant  to  

change,  but  not  because  of  repressed  motivation.  The  resistance  is  built  

into  the  machinery  of  the  brain/mind,  and  more  specifically,  its  

unconscious  networks  or  maps  containing  integrated  modes  of  

perception,  emotion,  cognition,  and  behavior  (Damasio,  2010;  Lewis  

and  Todd,  2007;  Panksepp  and  Biven,  2012).    

Two  aspects  influence  our  capacity  for  change:  the  power  of  

encoded  neural  networks  to  persist  and  the  brain/mind’s  innate  

tendency  to  enact  them  without  the  participation  of  conscious  intent.  In  

addition,  the  challenges  to  reaching  a  lasting  change  to  one’s  moods,  

affect  regulation  capacity,  ways  of  perceiving,  feeling,  and  relating  stem  

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from  the  wide-­‐spread  influence  of  unconscious  processes  (Curchland,  

2013;  Damasio,  2010;  Gazzaniga  et  al.,  2014)  their  involvement  in  all  of  

our  mental  functions.  An  integrated  neuropsychological  model  of  the  

unconscious-­‐conscious  continuum  will  greatly  expand  our  

understanding  of  the  all-­‐too-­‐human  obstacles  to  emotional  well-­‐being.    

The  neuropsychological  functions  of  unconscious  processes  

1.  One  of  the  exciting  developments  in  our  understanding  of  the  

unconscious  involves  the  greatly  expanded  picture  of  its  scope  of  action  

and  influence.  Unconscious  processes  are  brain/mind  functions  that  are  

pervasive  and  generally  much  more  influential  than  we  consider  them  

to  be.  Libet  (1985)  and  Libet  et  al.  (1967)  conducted  experiments  showing  that  brain  activity  preceded  seemingly  conscious  decisions  of  

subjects  instructed  to  raise  their  fingers  at  will.  Since  then,  it  has  

become  very  clear  that  unconscious  processes  are  involved  even  when  

we  feel  we  make  deliberate  choices.  As  neuroscience  continues  to  

demonstrate,  the  unconscious  is  in  essence  an  instrumental  system  that  

actively  relates  to  the  external  world  and  learns  through  perceptions,  

priming,  and  actions  (Bargh,  2007,  2014;  Hassin,  2007).  

2.  The  unconscious  is  grounded  in  learning  processes  rather  

than  rejected  or  defensively  dissociated  material.  The  brain’s  

efficiency  to  acquire  implicit  skills  and  patterns  is  central  to  all  

unconscious  processes.  These  patterns  represent  the  amalgam  of  

all  environmental  and  internal  learning  experiences;  from  the  

physio-­‐affective  ones  to  the  highest  cognitive  reasoning.  In  essence  

all  encoded  experiences  are  a  form  of  retention.  This  automatic  

learning,  especially  during  early  development,  is  in  the  service  the  

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important  tasks  of  survival,  adaptation,  and  the  maintenance  of  

wellbeing.    

3.  As  development  continues,  new  experiences  are  fitted  into  

existing  representations  and  neural  networks  that  integrate  

perception,  emotion,  thought  and  behavior.  We  can  see  how  the  

unconscious  will  look  for  confirmation  for  one’s  learned  

expectations.  In  other  words,  project  a  wide  range  of  expectations,  

then  “convince”  our  conscious  thought  processes  that  the  

projection  is  true  and  even  inevitable.  This  really  explains  

projective  identification.  

4.  Based  on  consolidated  learning,  the  unconscious  is  on  the  

lookout  for  what  it  is  primed  for,  for  what  it  already  knows  and  

expects.  People  who  tend  to  feel  rejected  will  scan  the  

interpersonal  field  for  behaviors  that  could  be  interpreted  as  

unwelcoming,  for  example.  They  will  experience  rejection  where  it  

does  not  really  exist  and  find  the  “right  evidence”  for  their  feelings  

and  thoughts.  Such  complex  processes  happen  out  of  awareness.    

5.  And  finally,  the  unconscious  is  in  essence  a  brain/mind  

system  that  actively  relates  to  the  external  and  internal  

environments  through  perceptions,  priming,  and  actions  (Bargh,  

2007,  2014;  Damasio,  2010;  Dijksterthuis  et  al.,  2007;  Glaser  and  

Kihlstrom,  2007;  Hassin  et  al.,  2007;  Koziol  and  Budding,  2010;  

Wegner,  2007).    

  How  did  conscious  and  unconscious  systems  evolve?  We  developed  these  capacities  in  our  distant  past  to  ensure  

survival,  adaptation,  and  life  management.    Following  the  critical  

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purpose  of  adaptation  there  was  evolutionary  pressure  to  acquire  a  

functioning  survival  system  that  could  act  quickly  and  without  

deliberation  but  still  efficiently.  We  did  indeed  develop  the  ability  to  

enact  behavioral  patterns  automatically  and  without  having  to  rely  on  

any  reflection  (Damasio,  2010;  Hassin  et  al.,  2007;  Koziol,  2014;  Koziol  

2014;  Wegner,  2007).    

With  time  another  slower  and  therefore  more  flexible  system  

developed  as  well.  This  reflective  capacity  has  led  to  thoughtful,  more  

deliberate  abilities,  and  executive  functions  that  depend  on  planning  

and  mindful  attention  (Damasio,  2010;  Koziol  and  Budding,  2010;  

LeDoux,  2002;  Lewis  and  Todd,  2007,  among  many  others).  What  is  

becoming  clear  is  that  despite  the  more  (relatively)  recent  development  

of  conscious  processes,  the  unconscious  ones  are  still  very  much  in  the  

picture.    Furthermore,  they  are  the  center  of  our  functioning.  Being  

ontologically  older  and  much  better  equipped  to  quickly  respond  to  

familiar  situations,  the  unconscious  realm  became  an  essential  mode  of  

functioning  that  is  still  part  of  all  our  mental  aspects.    

Studies  in  the  fields  of  sociology,  psychology  and  economics  give  

ample  evidence  that  unconscious  processes  monitor,  control,  and  guide  

the  way  we  pursue  goals,  and  largely  underpin  our  adaptive  approaches  

to  changes  in  the  environment  (Bargh,  2007,  2014;  Churchland,  2013;  

Glaser  and  Kihlstrom,  2007;  Eitam  et  al.,  2008;  Wilson,  2003).  The  

building  blocks  of  most  aspects  of  our  unconscious  processes  are  in  

actuality  on  a  continuum  with  conscious  ones.  Much  of  the  encoded  

content,  especially  that  which  goes  back  to  preverbal  time  is  not  

accessible  to  memory  or  reflection.  However,  through  repeated  

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behavioral  patterns  we  do  get  to  witness  the  nature  of  particular  

unconscious  self-­‐states  with  their  emotional,  cognitive  and  perceptual  

tendencies.  

 

Some  Developmental  Aspects  of  the  Unconscious:  Map  

                           Making  and  self-­‐states  

Unconscious  processes  are  the  embodiment  of  brain-­‐wide  neuronal  

connections  that  establish  maps,  models,  or  schemas  through  

synchronized  activation  and  inhibition  (Bucci,  2007a,  2007b).  At  any  

time,  a  fraction  of  such  networks  gives  rise  to  conscious  experiences  or  

conscious  self-­‐states  (Bromberg,  2011;  Damasio,  2010;  Koziol  and  

Budding,  2010).  Although  unconscious  systems  operate  out  of  

awareness,  they  are  active  and  constant  participants  in  our  perceptions  

and  responses  to  all  internal  and  external  stimuli.  Brain,  body,  and  

environment  are  inextricably  linked  at  all  times,  from  the  perception,  

sensations,  feelings,  and  interpretation  of  all  stimuli,  to  the  many  

responses  that  follow.  The  particular  ways  these  processes  entwine,  

persist,  and  are  enacted  give  unconscious  self-­‐systems  the  unique  

qualities  that  underpin  our  unique  personality  traits  (Colombetti,  2010;  

Di  Paolo  et  al.,  2010).  

The  sum  of  one’s  memories,  intersubjective  experiences  and  the  

often  distorted  meaning  given  to  them  by  the  child  during  early  

childhood  continually  establish  and  reinforce  our  unconscious  self-­‐

states  (Schore,  2012).  As  development  continues,  new  experiences  are  

fitted  into  existing  representations  and  neural  maps  (Damasio,  2010).  

This  further  strengthens  specific  adaptational  organizations  and  

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response  patterns  that  temporarily  but  successfully  maintained  the  

child’s  homeostasis.  In  this  adaptive  and  defensive  process,  perceptual,  

emotional,  cognitive  and  behavioral  tendencies  are  further  integrated  

into  unconscious  entrenched  maps.  These  networks  continue  to  scan  

the  environment  for  familiar  reminders,  and  treat  perceived  threats  and  

actual  challenges  according  to  old  implicit  knowledge  (Damasio,  2010;  

Engel,  2010;  Hassin,  2007;  Koziol,  2014;  Pally,  2000,  2007;  LeDoux,  

2002;  Lewis,  2005).  

The  developing  neuropsychological  patterns  are  quickly  and  

automatically  enacted  in  similar  contexts  (Stewart,  2010;  Wegner,  

2007).  Such  complex  patterns  can  pursue  goals  with  apparent  

motivation  and  determination,  but  without  conscious  will  or  plan  

(Bargh,  2007,  2014;  Koziol  and  Budding,  2010).  Conscious  awareness  is  

not  necessary  for  the  execution  of  many  of  our  emotional  and  

interpersonal  needs.  The  recurring  “choice”  of  an  unsuitable  partner  is  

one  example.  

Our  Implicit  Maps/Selves:  The  Case  of  Henry  

  Henry  started  therapy  when  he  was  43  years  old.  A  few  years  

prior  he  realized  that  his  “love  life  was  completely  crazy.”  He  dated  a  

number  of  women  and  yet  each  relationship  ended  when  he  felt  that  

there  were  things  he  didn’t  like  about  his  girlfriend.  Then  he  wanted  out  

and  looked  forward  to  the  next  one.  After  sinking  into  a  panicky,  highly  

dysregulating  feeling  that  he  might  end  up  alone,  he  sought  therapy.  

  From  the  start  of  Henry’s  therapeutic  process  it  became  clear  that  

throughout  his  adult  life  he  continually  enacted  repeated  patterns  of  

relating.  He  would  rapidly  fall  in  love  and  begin  a  relationship,  but  after  

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a  couple  of  years  nagging  feelings  of  being  trapped  in  a  relationship  that  

was  not  “good  enough”  would  cause  him  to  leave.  What  made  the  feeling  

of  being  trapped  even  stronger  was  a  recurrent  worry  that  he  had  to  

please  his  girlfriends.  He  was  not  fully  aware  of  these  automatic  

convictions,  but,  as  we  both  realized,  his  behaviors  indicated  that  upon  

establishing  a  relationship  he  would  lose  sight  of  his  own  desires  and  

needs.  Out  of  awareness  he  tried  to  predict  the  woman’s  wishes,  

anticipate  her  desires  and  in  essence  read  her  mind  while  not  knowing  

his  own.  Although  he  did  not  quite  understand  what  was  taking  place,  “it  

was  all  too  much”  for  him.  Thoughts  about  the  woman’s  shortcomings  

followed  and  the  relationship  would  end.  

  Henry’s  childhood  and  adolescence  provide  the  background  for  

his  repeated  pattern  of  losing  himself  in  the  other’s  subjectivity  and  

then  withdrawing.  It  was  easy  for  Henry  to  grasp  how  his  loving  but  

controlling  mother  shaped  his  relational  maps.  She  controlled  his  

freedom  by  not  allowing  him  to  go  to  most  social  events  with  his  school  

friends.  She  was  a  highly  anxious  woman  who  anticipated  the  worst  

possible  outcome  for  any  risk  and  she  frequently  warned  Henry  of  

imagined  dangers,  quizzed  him  on  his  whereabouts  when  he  did  leave  

home,  and  in  general  fretted  about  anything  that  had  to  do  with  her  

children.  

  In  reaction,  Henry  developed  an  exquisite  sensitivity  to  his  

mother’s  moods  and  fears.  At  the  same  time,  automatically  and  without  

awareness  he  also  desperately  tried  to  defend  against  being  swallowed  

up  by  her  powerful  fears  and  emotions.  A  pattern  of  oscillating  between  

loss  of  self  and  rebellion  was  established  unconsciously.  With  his  friends  

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he  oscillated  between  two  extremes;  after  bonding  with  them  and  

taking  on  their  traits,  he  often  withdrew  and  preferred  being  alone.  As  

he  grew  into  young  adulthood  he  alternately  enacted  these  two  

seemingly  opposing  self-­‐systems  in  his  romantic  encounters.  After  

falling  in  love  and  striving  to  adapt  to  the  woman’s  needs,  he  would  

eventually  reject  the  experience  of  his  diminished  sense  of  self,  feel  

trapped  and  end  the  relationship.  As  this  oscillation  was  increasingly  

enacted  between  us,  both  Henry  and  I  were  able  to  directly  experience  

the  intensity  of  his  conflicting  self-­‐states.  

  Our  understanding  of  Henry’s  problematic  patterns  and  their  

powerful  hold  on  his  emotional  life  can  be  convincingly  explained  

through  a  neuropsychological  model  of  unconscious  processes.  This  

vignette,  like  many  neuropsychological  findings,  illustrates  the  power  of  

internal  maps  to  enact  intrsubjectively  rooted  emotional  and  

interpersonal  dynamic  patterns.      

The  Enacted  Unconscious:  How  we  recognize  unconscious  patterns  

The  importance  of  recognizing  the  unconscious  has  always  been  a  

crucial  aspect  of  psychoanalysis  and  dynamically  oriented  

psychotherapy.  For  example,  the  ability  to  become  aware  and  reflect  on  

unconsciously  driven  emotional  and  interpersonal  difficulties  is  

considered  a  necessary  precursor  to  affect  regulation  and  integration  

(Cozolino,  2002;  Fonagy,  2008;  Freud,  1915;  Siegel,  2007;  Wallin,  2007).  

But  the  understanding  as  to  how  we  recognize  the  unconscious,  its  

effects,  and  its  manifestations  is  rapidly  changing.  Slips  of  the  tongue  

and  free  associations,  for  example,  have  long  been  thought  to  get  to  

what  is  hidden  and  give  us  clues  about  out  of  awareness  wishes,  

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conflicts,  and  motivation.  But  because  physio-­‐affective,  cognitive,  and  

behavioral  processes  are  all  enmeshed  within  brain/mind  processes  

and  structures,  the  words  uttered  as  slips  of  the  tongue  or  free  

associations,  “uncensored”  as  they  might  be,  are  too  limited  to  get  to  the  

heart  of  the  unconscious.  Words  alone  cannot  convey  the  complexity  of  

the  intertwined  neural/mental  procedures  that  embody  an  unconscious  

self-­‐system  (Churchland,  2013).  But  although  words  may  fall  short  at  

revealing  our  unconscious  properties,  it  is  becoming  exceedingly  clear  

that  enacted  affects,  thoughts,  and  behaviors  can.  

As  neuropsychological  data  indicates,  the  typical  ways  through  

which  we  experience,  react  to  and  negotiate  our  internal  and  external  

environment  can  give  us  a  glimpse  into  our  unconscious  self-­‐systems.  

The  intertwined  proximity  of  the  motor  areas  in  the  brain  to  all  other  

functions  explains  the  brain’s  tendency  to  enact  entrenched  patterns  

automatically  and  without  deliberation.  In  particular,  the  influence  of  

subcortical  regions  such  as  the  basal  ganglia  and  the  cerebellum  

underpin  our  learned  responses  quickly  and  thoughtlessly.  We  

automatically  react  with  our  well-­‐established  unconscious  patterns  and  

explain  our  behavior  later.  Remember  again  that  all  patterns  are  the  

integrated  amalgam  of  perceptual,  emotional,  cognitive  and  behavioral  

functions,  and  the  experiences  and  memories  that  created  them.  

This  is  what  the  brain  does  well.  Automatically,  and  out  of  

awareness  it  implements  past  lessons  so  that  we  do  not  have  to  relearn  

things  each  time  anew.  The  repeated  enaction  (a  very  useful  term  

coined  by  Varela  et  al.,  1991)  of  neural/self-­‐systems  or  patterns  gives  

expression  to  perceptual  biases,  emotional  patterns,  automatic  cognitive  

  11  

interpretations,  successful  actions,  and  defenses.  Varela  et  al.,  like  many  

others  after  them  (e.g.  Koziol,  2014),  stress  the  embodied  properties  of  

the  mind  and  their  tendency  to  be  enacted  on  the  environment.  

Although  not  holding  a  psychodynamic  view,  they  highlight  the  

intersubjective  aspects  we  often  experience  in  the  therapeutic  process.  

These  transference-­‐countertransference  aspects  are  especially  

experienced  during  enactments  when  emotions,  expectations  and  self-­‐

narrative  are  acutely  felt,  projected,  and  acted  on  (see  Ginot,  2009,  

2012,  2015).  

This  process  of  re-­‐creation  happens  automatically  and  out  of  

awareness  whenever  we  interact  with  and  respond  to  the  external  

environment  and  to  signals  arising  from  within  us.  Past-­‐encoded  self-­‐

systems  are  always  being  resurrected  in  the  present  time.  They  blend  

the  past  and  the  present  and  the  conscious  and  the  unconscious  

(Chartrand  et  al.,  2007;  Gendlin,  2012;  Horga  and  Maia,  2012).  Such  

processes  were  evident  in  Henry’s  unconscious  relational  patterns.    

 

                             Self-­‐Other  Narratives  as  Expression  of    

               Unconscious  Self-­‐Systems  

 

This  section  explores  one  of  the  most  familiar  characteristics  

of  unconscious  self-­‐states  or  maps:  the  all-­‐consuming  and  utterly  

believable  negative  convictions  and  narratives  about  the  self  and  

others.  These  emotional/cognitive  beliefs,  frequently  distorted,  

are  an  inseparable  part  of  unregulated  emotional  states.  Such  self-­‐

other  narratives  can  acquire  an  intrusive,  autonomous  life;  they  

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surface  unbidden  and  flare  up  as  familiar  thoughts,  fantasies  or  

images.  They  end  dominating  our  intra-­‐psychic  and  interpersonal  

experience.  As  an  expression  of  unconscious  self-­‐systems,  negative  

narratives  that  automatically  rise  to  the  surface  during  

dyregulation,  can  shed  light  on  unconscious-­‐conscious  processes.  

In  essence,  a  recurrent  negative  narrative  about  the  self  or  

others  gives  a  dysregulated  state  its  familiar  shape  and  feel,  and  

intensifies  its  harmful  qualities.  In  the  midst  of  a  dysregulated  

state  the  visceral,  emotional,  and  cognitive  are  totally  intertwined;  

feelings  are  fueled  by  words,  and  the  words  we  tell  ourselves  

reinforce  the  negative  state.  Neurally  and  therefore  experientially,  

they  are  one  and  the  same  (Sergerie  and  Armony,  2006).  To  quote  

Panksepp  and  Biven  (2012,  p.  451):  “in  humans  these  [affective  

states]  are  always  accompanied  by  cognitive  changes,  such  as  

emotionally  entangled  attributions,  ruminations,  all  sort  of  plans  

and  worries.”  These  joined  expressions  of  emotion  and  thought  

embody  an  important  aspect  of  our  unconscious  and  reveal  a  great  

deal  about  one’s  implicit  patterns.    

  As  we  see  in  our  clinical  work,  such  narratives—easily  

activated  during  stressful  situations  or  in  the  transference—tend  

to  be  harsh  and  judgmental.  They  tend  to  be  distorted,  at  times  

clearly  removed  from  one’s  impartial  reality.  How  is  it  that  a  more  

balanced  perspective  is  lost  and  what  remains  is  the  conviction  

that  one’s  negative  assessment  of  the  present  situation  is  the  only  

correct  one?  Being  an  integral  part  of  unconscious  maps,  such  

narratives  repeatedly  enact  unconscious  self-­‐states,  bringing  

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hidden  emotions,  experiences  and  memories,  and  the  cognitive  

beliefs  and  interpretations  embedded  within  them,  to  the  fore.  

A  Brief  Example:  The  Case  of  Amy  

Amy,  a  professional  woman  in  her  thirties,  sought  therapy  on  

starting  a  new  job,  for  which  she  had  undergone  weeks  of  stressful  

interviews.  In  spite  of  her  wish  for  a  smooth  transition,  she  

experienced  strong  feelings  of  discomfort  and  anxiety  from  the  

first  day  in  her  new  position,  as  well  as  physical  symptoms  of  light-­‐

headedness,  palpitations,  and  shortness  of  breath.  These  feelings  

were  followed  by  a  state  of  inertia  and  fatigue.    

She  was  terrified  she  might  not  be  able  to  fulfill  the  demands  

of  the  new  job.  Thoughts  of  inevitable  failure  were  constantly  on  

her  mind.  She  was  certain  she  was  already  failing  because  she  was  

not  proving  herself  fast  enough,  and  thereby  disappointing  those  

who  had  placed  trust  in  her.  Attempting  to  unsuccessfully  fight  her  

anxious  feelings  and  the  familiar  sense  of  lethargy  that  followed  

only  made  her  feel  more  defeated.  At  this  point  she  came  for  

treatment.  

From  the  beginning  of  therapy,  Amy  knew  that  in  the  past  she  

had  successfully  held  a  great  deal  of  responsibility  in  very  visible  

positions.  She  was  quite  familiar  with  the  new  job’s  environment,  if  

not  its  details.  In  spite  of  these  realizations,  her  discomfort  did  not  

lessen;  on  the  contrary,  it  grew  to  a  painful  and  distracting  level.    

Glumly,  she  said  that  because  she  felt  so  exhausted,  she  had  a  

difficult  time  actually  achieving  what  she  most  wanted:  to  become  

engaged  again  and  perform  successfully.  What  quickly  became  

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apparent  was  Amy’s  repeated  pattern  of  “falling  apart”  each  time  

she  started  a  new  project,  always  sinking  for  a  while  into  what  she  

experienced  as  a  confusing  disconnect  from  reality.  She  knew  she  

was  capable,  and  yet  had  no  access  to  her  feelings  of  competency.  

In  school  each  new  grade  and  later  each  new  work  situation  began  

with  the  same  self-­‐doubts  and  intense  fears  of  being  judged.  The  

question  that  perplexed  her  most  concerned  her  inability  to  “learn  

from  reality.”  After  all,  she  had  gone  through  these  experiences  in  

the  past  but  ended  up  performing  well,  ultimately  enjoying  both  

school  and  work.  

Her  puzzlement  about  the  repetitious  nature  of  his  

dysregulated  states  captured,  in  effect,  the  tenacity  of  implicit  

cognitive/affective  states  associated  with  particular  situations.  It  

highlighted  the  difficult  if  not  impossible  task  of  differentiating  

between  the  dysregulated  affect  triggered  by  perceived  threat  and  

the  automatic  way  of  thinking  that  is  part  of  it.  Amy’s  difficulties  

remind  us  that  during  dysregulation,  the  distorted  narratives  

about  the  self  are  subjectively  experienced  as  entirely  couched  in  

objective  facts.  In  this  case,  under  the  normal  stress  of  a  new  job,  

an  unconscious  internal  certainty  of  extreme  self-­‐doubt  and  fear  of  

being  incompetent  became  the  only  dimension  of  Amy’s  

experience.  

 

                                                                 The  Nature  of  self-­‐Narratives  

As  depicted  in  Amy’s  case,  these  ruminations  in  effect  give  a  

more  conscious  articulation  to  unconscious  self-­‐other  

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representations.  By  embodying  early  intersubjective  and  

developmental  processes,  self-­‐narratives  represent  an  integrated  

portrait  of  the  conscious  and  the  implicit,  the  affective  and  the  

cognitive.  All  these  elements  are  collapsed  into  an  unshakable  

story  line  that  becomes  an  inseparable  part  of  one’s  self-­‐definition  

during  a  dysregulated  self-­‐state.    

Self-­‐narratives  originate  from  the  child’s  tendency  to  be  

immersed  in  his  parent’s  experiences  and  self-­‐states  and  the  

child’s  efforts  to  give  meaning  to  these  experiences,  especially  

hurtful  and  painful  one.  In  attempting  to  make  sense  of  and  

interpret  emotions  and  bodily  sensations  as  they  are  occurring  in  

response  to  parental  hurtful  behavior,  the  child’s  “conclusions”  

regarding  the  self  largely  are  self-­‐centered  and  turned  against  the  

self.    

Paradoxically,  the  child’s  other-­‐centered  immersion  in  

parental  self-­‐states  (Brate,  2007)  results  in  the  learned  distorted  

convictions  that  are  turned  against  the  self.  The  child  does  not  

possess  yet  enough  brain/mind  maturity  to  understand  his  

parent’s  culpability  in  a  painful  interaction;  the  parent’s  

experience  becomes  his  own,  their  anger  results  in  his  guilt.  Amy’s  

father,  not  surprisingly,  was  a  stern,  critical  man.  Her  searing  

shame  and  humiliation  in  response  to  his  criticalness  and  

demanding  attitude  was  interpreted  by  her  immature  

understanding  as  her  own  deficiency  rather  than  his.    

  These  interpretations  and  beliefs  became  part  of  a  self-­‐state  

containing  all  the  memories,  associations  and  learned  behaviors  

  16  

that  related  to  specific  situations  in  which  Amy  felt  her  

performance  was  going  to  be  judged.  The  child’s  inability  to  

understand  the  context  of  events  and  the  parent’s  own  emotional  

difficulties  and  human  shortcomings,  parts  of  the  developing  self-­‐

image  can  become  painfully  distorted.    

But  as  the  child  learns  to  internalize  both  aspects  of  the  

intersubjective  interaction,  he  also  learns  to  be  angry  with  himself  

and  others.  Again,  unsurprisingly,  Amy  was  extremely  critical  not  

only  of  her  self,  but  of  others  as  well.  As  the  expression  of  a  largely  

implicit  intersubjective  past,  self-­‐narratives  are  often  also  

triggered  within  the  psychotherapeutic  dyad.  Like  enactments,  

they  can  become  an  inescapable  part  of  the  therapeutic  interaction  

and  reveal  a  great  deal  about  a  particular  unconscious  self-­‐system.    

The  expressed  convictions,  then,  represent  an  entire  

unconscious  self-­‐system,  with  its  unique  emotional  tones,  physical  

sensations,  implicit  and  explicit  attachment  memories,  and  the  

cognitive  interpretations  given  to  them—conscious  and  

unconscious  alike  (Bromberg,  2006).  In  this  way,  self-­‐narratives  

can  be  seen  as  the  consciously  felt  manifestation  of  an  unconscious  

system  (Bromberg,  2006;  Bucci,  2007a,  2007b;  Damasio,  2010;  

Ginot,  2007,  2009;  Lewis  and  Todd,  2007;  Panksepp  and  Biven,  

2012).    

As  we  dig  deeper  clinically,  we  often  see  that  even  when  

experientially  dissociated  from  the  sense  of  self,  emotions  can  be  

conveyed  through  narratives  or  one’s  actions  in  the  world.  One  

may  feel  numbness,  defeat,  or  emptiness,  but  the  accompanying  

  17  

narratives  still  embody  a  feeling  state,  albeit  a  hypo-­‐aroused  one.  

In  extreme  splits  seen  among  highly  dissociative  patients,  self-­‐

narratives  may  be  the  only  manifestation  of  their  hidden  

emotional  and  relational  core.    

 

                     Obstacles  to  change:  Repetition  and  automaticity  

The  implications  of  these  unconscious  processes  for  understanding  

patients’  difficulties  are  manifold.  Maps  or  self-­‐systems  are  central  to  

the  formation  and  maintenance  of  the  defenses  we  instinctively  marshal  

to  deal  with  physical  and  emotional  threats.  Homeostatic  pressures  

demand  responses  that  lead  to  relief  or  reward—to  a  state  of  

resolution—even  if  these  reactions  and  defenses  are  only  good  

temporarily  and  are  not  adaptive  in  the  long  run  (Schore,  2012;  Eitam  et  

al.,  2008)  as  in  Henry’s  case.  

Unconscious  self-­‐systems  repeat  themselves  when  the  influence  

of  subcortical  regions  (e.g.  the  cerebellum  and  the  basal  ganglia)  

overrides  the  influence  of  higher-­‐level  cortical  areas.  When  this  

happens,  subcortical  neural  messages  bias  the  prefrontal  cortex  to  

interpret  perceptions  in  an  inflexible  way  that  entirely  relies  on  old  

maps  and  patterns.  New  information  is  not  processed.  In  an  

interpersonal  situation  for  example,  when  an  entrenched  prediction  is  

biased  toward  a  humiliating  outcome,  as  in  Amy’s  unconscious  world,  

the  subcortical  networks  release  old  behaviors  that  successfully  

relieved  shame  in  the  past,  regardless  of  their  adaptability  to  new  

situations  (Koziol,  2014).  Justifying  her  father  was  the  only  option,  and  

relieved  Amy  of  her  own  pain.  Such  predictions  regarding  perceived  

  18  

emotional  or  interpersonal  threats  are  based  on  an  internal  model  

alone,  so  they  do  not  take  into  account  the  many  different  aspects  

embedded  in  the  current  reality.  These  faulty  predictive  processes  

encoded  long  ago  may  lead  to  distorted  expectations  and  predictions  

(Pally,  2000,  2007).    

The  links  between  conscious  and  unconscious  functioning,  e.g.  

between  subcortical  regions  and  the  prefrontal  cortex  and  its  various  

executive  functions  (Donald,  2001)  explain  the  sway  unconscious  

processes  have  over  higher  executive  functions.  This  link  also  leads  to  

the  automatic  and  out-­‐of-­‐awareness  implementation  of  complex  

motivations  and  activities,  belief  systems,  and  goal  pursuit  that  are  

executed  over  long  periods  of  time  (Bargh,  2007,  2014;  Wilson,  2003).  It  

is  important  to  underline  the  brain/mind’s  propensity  to  employ  

existing  maps  in  the  constant  effort  to  make  sense  of  and  interpret  

reality.    

We  can  all  recognize  in  ourselves  this  tendency  to  see  the  world  

according  to  what  we  already  know,  according  to  our  subcortical  maps.    

The  brain/mind  favors  automaticity  (Chartrand  et  al.,  2007;  Wegner,  

2007.  An  automated  response  is  one  that  occurs  without  conscious  

participation,  biasing  the  PFC  to  release  old  patterns  in  a  rigid  and  

repetitive  way.  Imaging  studies  show  that  automatic  behaviors  demand  

less  effort  and  stimulate  less  activation  than  deliberate  behaviors.    

Similarly,  there  is  a  decrease  in  brain  activation  during  learning  which  

indicates  that  representations  within  the  brain  have  become  more  

efficient  as  automaticity  has  taken  hold  (Damasio,  2010;  Koziol,  2014).  

 

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       The  (im)possibility  of  change:  Concluding  thoughts  

 

This  continuous  tug  explains  how  unconscious  patterns  seem  to  have  a  

life  of  their  own,  often  winning  over  conscious  intention  and  wishes.  

This  characteristic  explains  what  we  often  witness;  a  tendency  to  feel,  

behave,  and  interpret  the  world  in  very  familiar  and  predictable  ways,  

even  when  circumstances  differ.  These  guiding  systems  work  against  us.  

It  explains  why  the  occasional  insight  and  even  a  determination  to  act  

differently  are  necessary  but  not  sufficient  for  enduring  change.    

On  the  other  hand,  the  more  deliberate  higher-­‐order  functions  provide  

autonomy  from  automatic  reactions  (Batemand  and  Fonagy,  2012).    

  Unless  mindful  efforts  are  exerted  in  the  midst  of  dysregulation  

(Jurist,  2008),  the  quick  and  automatic  activation  of  subcortical  

networks  can  over-­‐ride  the  slower  and  reflective  prefrontal  cortex  

(Lane  et  al.,  2014;  LeDoux  and  Doyere,  2011;  McRae  et  al.,  2013).  

Understanding  the  powerful  forces  of  repetition  and  resistance  while  at  

the  same  time  attempting  to  empathically  nudge  patients  toward  

greater  awareness  will  be  therapeutically  successful  (Ginot,  2012,  

2015).  All  therapeutic  changes  are  really  changes  in  neural  networks,  

the  emotional  network  in  particular,  and  the  connections  among  them  

(Ecker  et  al.  2012).    

As  these  psychologists  and  researchers  have  shown,  both  

affect  and  reflection  are  needed  simultaneously  in  order  to  

modulate  persistent  patterns.  Being  the  emotional  engine  for  a  

great  deal  of  implicit  leaning  and  memories,  the  therapeutic  

experience  of  affective  states  is  essential.  Reflective  awareness  in  

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real  time,  while  experiencing  the  emotional  state,  can  provide  a  

new  perspective  that  in  turn  enhances  affect  regulation.  Change  

may  be  more  difficult  for  some  patients  compared  with  others,  as  the  

potential  effects  of  a  flexible–rigid  continuum  are  always  at  work.    

As  part  as  of  any  therapeutic  process  we  need  to  recognize  and  

address  the  built  in  difficulties  that  resist  change  and  unconsciously  and  

automatically  repeat  established,  relational,  defensive,  emotional  and  

behavioral  patterns.  A  better  knowledge  of  unconscious  processes  and  

their  embeddedness  within  our  neurobiology  will  enable  both  

psychotherapists  and  patients  to  tackle  and  ameliorate  difficult  patterns  

with  more  empathy  and  effectiveness.  Understanding  the  power  of  

reflective  awareness  to  slow  down  harmful  automatic  processes  (Siegel,  

2007)  can  offer  a  path  towards  sustained  change  

 

 

 

 

 

 

 

 

 

 

 

 

 

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                                                                                       References  

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